Prognostic significance of residual lymph node status after definitive chemoradiotherapy in patients with node-positive cervical cancer
2018
Abstract Objective
Lymph nodeinvolvement is an important prognostic factor in patients with cervical cancer. However, the prognostic significance of
lymph noderesponse to
chemoradiotherapyremains unclear. We retrospectively analyzed the relationship between
residual
lymph nodestatus after definitive
chemoradiotherapyand survival. Methods We enrolled 117 patients with node-positive cervical cancer. All patients were treated with definitive
chemoradiotherapyin our institution, from 2006 to 2016. The median follow-up period was 41months (range, 6–128months). The criterion for a positive
lymph nodewas defined as a maximum short axis diameter of ≥8mm on pretreatment magnetic resonance imaging (MRI)/computed tomography (CT) scans. Posttreatment pelvic MRI was obtained 3months after the completion of
chemoradiotherapy.
Residualprimary tumor was defined as any
residuallesion identified upon clinical examination and/or MRI.
Residual
lymph nodewas defined as any
lymph nodewith a short axis diameter of ≥8mm posttreatment, according to MRI/CT. Results At follow-up, 3months after
chemoradiotherapy, we observed
residualprimary tumor in 30 patients (25.6%), and
residual
lymph nodein 31 patients (26.5%). The presence of
residual
lymph nodewas associated with worse overall survival according to multivariate analysis (hazard ratio, 3.04; 95% confidence interval, 1.43–6.44; p=0.004). In the 5-year time-dependent ROC analysis of survival prediction, the presence of
residual
lymph nodeshowed an AUC value of 0.72. Conclusions The presence of
residual
lymph nodeafter
chemoradiotherapywas associated with worse survival in patients with node-positive cervical cancer.
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